As explained in our section on why the early years are so important, the first 1,001 days of life are crucial for brain development and can impact the rest of our lives because of this. As such, preventing ACEs, building resilience and ensuring other levels of optimum development during this period should be the number one priority for any Government wishing to create a healthy society.

This approach is known in health circles as ‘primary prevention’, as it is focused on preventing disease and injury before they even occur, as opposed to reducing their impact once they have occurred (secondary prevention) or softening the impact of an ongoing illness or injury that has lasting effects (tertiary prevention). We all know that an ounce of prevention is worth a pound of cure and primary prevention from the point of conception onwards is applying this logic in the most effective way possible.


For a local authority to implement a comprehensive primary prevention package, they would need to include the best available programmes and systems for the following:


  • Pre-birth risk assessments for child maltreatment risk factors, including domestic violence, mental health issues and drug or alcohol abuse.
  • Support for these issues, including addiction and perinatal mental health services.
  • Pre-birth parenting classes, followed by immediate post-natal support.
  • Post-natal risk assessments for attachment and attunement.[1]
  • Support where secure attachment and high-quality attunement are lacking.
  • Speech and language support programmes.
  • Other effective prevention programmes could include empathy classes in schools for children and home visit support for vulnerable mothers.


WAVE also recommends:

  • That national Government establishes a ‘1001-days’ strategy fund to support local authorities and CCGs to make a decisive switch over the next 5 years to a primary preventive approach in the first 1001 days of life. Practical support would also be provided, including the measures of success.
  • That local authorities, CCGs and Health & Wellbeing Boards be required to prioritise all factors leading to the development of socially and emotionally capable children at age 2 by:
    1. Adopting and implementing a ‘1001-days’ strategy and showing how they intend to implement it within 5 years in collaboration with partner agencies.
    2. Investing in preventive policies and practices – not evidence/ science-based programmes alone, but also systemic changes.
    3. Using a Collective Impact Model of working (see Stanford Social Innovation Unit; The Process of Social Innovation, 2006)
    4. Encouraging pooling of service providers’ budgets at local level.
    5. Educating all service providers and users in early years (including health visitors, midwives, early years’ experts, etc) about ACEs and their lifelong impacts.
    6. Educating and training all those in point 5. above in how to adopt and deliver trauma-informed care.
    7. Implementing trauma-informed care practices as standard in all services used during parents and children during this period.